None of the literature in the field of terminal care provides a full treatment of the laws, documents, and policies relating to the difficult issues arising at the end of life. When Life Ends was written to fill this gap by an attorney who serves on the bioethics committee of a large public hospital. It is an invaluable resource and practical tool for physicians, nurses, medical staffs, legal professionals, hospital administrators, and hospital bioethics committees because it provides: 1) in-depth legal commentaries on the refusal of life-sustaining treatment, advance directives, surrogate decision making, and the Patient Self-Determination Act; 2) more than 70 medical and legal documents to be used in connection with end of life decisions; and 3) hospital policies and procedures to suggest guidelines to hospital bioethics committees as they carry out their functions of developing policies and procedures to address end of life legal and ethical issues.

The second edition of the Handbook of Pain Relief in Older Adults: An Evidence-Based Approach expands on the first edition by providing a number of timely new features. Most important of these are the revised recommendations from the American Geriatrics Society on prescribing that reflect the many new agents available since the last guidelines were released in 2001. Additionally, concepts such as synergy in prescribing for older adults have been better delineated in this edition. The most salient features of the original edition have been retained and updated, including the full range of approaches for pain assessment and prevention, interventional strategies, guidance on pharmacotherapy and nonpharmacologic pain relief strategies for seniors, preventive analgesia, the role of rehabilitation in sound pain treatment, legal and public policy issues in pain care for seniors, pain management in long-term care, and even the issue of spirituality as an adjunct to pain management. The second edition also includes a new chapter on resources, which includes organizations, internet websites, and guidance on acquiring additional consultation for pain intervention. Of particular interest is an updated discussion of the effect that electronic medical records and internet-based personal health records will have on pain relief in older adults and a new chapter that serves as a resource guide for patients and caregivers trying to navigate the waters of pain relief assistance. This issue has not been addressed substantively in the pain management literature and the ramifications for older adults are particularly poignant. Comprehensive and practical, the Handbook of Pain Relief in Older Adults: An Evidence-Based Approach (Second Edition) is a comprehensive resource with targeted, practical information that will be of vital importance for all clinicians who provide care for seniors.

This treatise commemorates the 32nd anniversary of the first successful allogenic kidney transplant in a human being and the beginning of a con tinuing challenge for well over a generation of anesthesiologists. If compari sons can be permitted, this epoch-making event can be ranked with the first pulmonary lobectomy and subsequently the initial ligation of a patent ductus arteriosus in the late 1930s when thoracic and cardiac surgery began. Was it merely a coincidence that brought these events to the fore so close upon one another after many years of ideation and frustration? Not so, according to Lewis Thomas, for this was the time of medicine's second revolution-its transformation from an empirical art into a powerfully effective science. The remote Galenic conception of disease with its emphasis on disturbed body humors was about to be supplanted by effective therapeutics, as signified by the introduction of the sulfonamides and antibiotics for the specific treatment of infection. Anesthesiology had been dormant up to that era, still relying upon a few agents, more or less utilized from the beginning, and purveyed by a handful of specialists who had not yet begun to ask the scientific questions necessary for their maturation into a bona fide discipline. However, anesthesiology was in evitably caught in the ferment, for as Peter Caws observed, "It serves to re mind us that the development of science is a step-wise process: nobody starts from scratch and nobody gets very far ahead of the rest."

Pain medication is widely used to treat patients who suffer from acute and chronic pain. however, it is not the only treatment option available for managing traumatic and chronic upper body pain. Chinese medicine is a popular option without the risk of adverse side effects that may come with opioid use. Chinese Medicine for Upper Body Pain further explores other pain management options, introducing treatments such as acupuncture, herbal medicine, and Tui Na (Chinese bodywork). This book provides concise explanations in terms of anatomy, pathology, and etiology for both Western and Chinese medicine, and also provides selfcare instructions that are effective and easy to follow. Key Features: Introduces treatments in Chinese medicine including acupuncture with traditional methods such as acupuncture point selection and its modifications, electroacupuncture, point bleeding, auricular medicine, cupping, and moxibustion; herbal formulas with their sources and modifications, and Tui Na therapy Recommends dietary, exercise, and selfcare protocols for patients Includes photos for reference and ease of understanding This book is suitable for healthcare practitioners and students of Chinese medicine practices as well as patients who want to better understand and mitigate their pain. Along with Chinese Medicine for Lower Body Pain (ISBN: 9780367235857), the author covers the use of Chinese medicine for pain management for the complete body.

Linking theory to practice through the use of authentic clinical cases, Dr. Steven D. Waldman's Pain Medicine: A Case-Based Learning Series helps readers acquire the valuable skill of effective diagnostic thinking in daily practice. The Spine volume uses an in-depth case format, preparing you to correctly analyze clinical vignettes and formulate a clinically sound, evidence-based approach to realistic patient scenarios. This highly effective leaning and assessment tool provides practical clinical insights into the best methods for diagnosis and treatment for the successful management of patients with spine-related pain. Presents real-world patients in a real-world clinical setting, making learning fun and engaging. The Case-Based Learning approach focuses learners and clinicians on the key elements for each diagnosis and helps develop a deep understanding of how to diagnose and treat each condition. Covers everyday clinical problems such as Herniated Disc, Lumbar Strain, Thoracic Vertebral Compression Fracture, Epidural Abscess, Spondylosis, Spinal Stenosis, Sacroiliac Joint Pain, and more. Cases unfold just the way they do in your clinic. Each case is accompanied with thoughtful clinical commentary and key messages from the author. Each chapter uses high-quality radiographic images, clinical photos, and full-color drawings to facilitate a clear, easy-to-understand approach to evaluation and diagnosis. An ideal self-assessment and review tool for pain medicine practitioners and trainees, as well as those preparing for the American Board of Anesthesiology Pain Medicine certification and recertification exam. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

"I just wish I had armfuls of time." These are the words of a four year old facing a life-threatening illness. This text portrays the psychological experience of such children, who are irreversibly changed from the moment of diagnosis. Barbara Sourkes is a psychologist who specializes in psychotherapy with children who have cancer and other serious diseases. In the account, she describes how she works with these children, using drawings, soft toys and dolls, stories and real medical instruments to allow them to communicate their experience of the illness, the treatment they undergo, their relationship with their families, and their feelings of grief and loss in coming to terms with the prospect of death. Making use of the words of children, offering interpretations and practical advice, this is a book that should be useful reading for those concerned with the care of terminally ill children.

This empowering book provides a comprehensive resource to help readers of all ages understand pain, seek the right diagnosis and treatment, and allow them to take control of their pain. Unfortunately, pain is a universal human experience. For many, their experience of pain transcends an occasional or nagging discomfort and disrupts their lives. Understanding Pain: What You Need to Know to Take Control presents insights that will be useful to anyone who wants to be more knowledgeable about recognizing pain conditions through symptoms and telltale signs, and needs to be fully informed about the various treatment options available. Providing information that is at once cutting-edge, comprehensive, and easy-to-understand, the chapters also provide the resources needed to obtain further information about the topic. The book covers all major pain syndromes in a manner accessible to those without backgrounds in science or pain treatment, explicitly explaining symptoms, tests that may be needed, and treatments and rehabilitation techniques that are possible. The last section of the text discusses pain issues of specific populations, such as children, the elderly, and women during childbirth. Contributions from experts from across the country in their respective fields-real-life, dedicated practitioners who treat patients and conduct research

Theodore H. Stanley, M. D. Anesthesiology and the Heart contains the Refresher Course manuscripts of the presentations of the 35th Annual Postgraduate Course in Anesthesiology which took place at The Cliff Conference Center in Snowbird, Utah, February 16-20, 1990. The chapters reflect new data and concepts within the general framework of "evaluating myocardial function," "pharmacology and the cardiac patient," "anesthesia for patients with cardiac disease," and "stress, cardiopulmonary bypass, coagulation problems and related issues. " The purposes of the textbook are to 1) act as a reference for the anesthesiologists attending the meeting, and 2) serve as a vehicle to bring many of the latest concepts in anesthesiology to others within a short time of the formal presentation. Each chapter is a brief but sharply focused glimpse of the interests in anesthesia expressed at the conference. This book and its chapters should not be considered complete treatises on the subjects addressed but rather attempts to summarize the most salient points. This textbook is the eighth in a continuing series documenting the proceedings of the Postgraduate Course in Salt Lake City. We hope that this and the past and future volumes reflect the rapid and continuing evolution of anesthesiology in the late twentieth century. vii LIST OF CoNTIUBUTDRS Bailey, P. L. Department of Anesthesiology, The University of Utah School of Medicine, Salt Lake City, UT 84132, U. S. A. Barash, P. Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510, U. S. A. Covino, B. G.

The Primary FRCA Structured Oral Examination Study Guide 2 is the definitive revision aid to the Primary FRCA structured oral examination. This second edition is revised and updated in line with the new Royal College of Anaesthetists 'Guide to the Primary FRCA', with over 20 new topics to reflect changes to the RCoA's model questions and major revisions to graphs, diagrams and many of the pre-existing sections. Packed with new guidelines and current hot topics, this second volume covers pharmacology, special patient groups and critical incidents in depth. Over 37 pharmacology topics are covered including mechanisms of drug action, dose-response curves, drug interactions, half-life, variations in drug metabolism, opioids, neuromuscular blocking drugs and more. Twelve special patient groups topics are covered including paediatrics, elderly, pregnancy, diabetes, hypertension and more. Over 20 critical incidents topics are covered including aspiration, cyanosis, bradycardia, failed intubation, ST segment changes, hypoxia and more. The second edition of this hugely popular book is improved in clarity and content but stays true to the pragmatic approach adopted by the authors in the first edition.

This interactive workbook covers all the physiological and pharmacological aspects of pain and pain control. Each topic such as the central nervous system, the human experience of pain and pain management is concisely covered in nine separate sessions. The workbook includes activities, assignments, worked examples, self-assessment questions relating to learning objectives and learner profiles to assess current knowledge. The style is clear with diagrams, personal profiles, resources and areas to make your own notes. It is a companion to the text listed below and is a valuable tool for initial training and professional development.

The ability to interface patient monitors directly to a computer, and generate a clinical record has existed for over 20 years. However, the acceptance of comprehensive electronic medical records in anesthesia has been slow to develop. Experts anticipate this reluctance is changing because of enhanced patient care through the use of detailed health information record systems. Anesthesia Informatics provides the health informatician and administrator with a comprehensive overview of this blossoming technology. With contributions from leaders in the field, this user-friendly guide addresses how this technology has enhanced both the need for and the ability to collect and apply data in an acute care setting. It also offers invaluable insight on the business implications and the rationales required to make a purchase decision. Each section outlines need to know information to help the reader with the implementation and utilization of an Anesthesia Information Management System. Useful case scenarios focus on the ideal components (anesthesia record, business rationale, communication, collaboration, and training) of a fully automated record-keeping system.

Easy to read and follow, Essentials of Equipment in Anaesthesia, Critical Care and Perioperative Medicine makes an otherwise dry subject digestible and easy to learn. This practical textbook comprehensively covers all the equipment used in the operating theatre and intensive care unit, including why it is used and any related safety concerns. It has been fully updated in its sixth edition to include new technologies introduced during the Covid-19 pandemic. This is ideal as the main text for all trainees undertaking the primary FRCA exams and is also suitable anyone who works with anaesthetic equipment, including anaesthetic and intensive care nurses and operating department practitioners. It features concise and consistent text and illustrations, self-assessment features, and exam tips. Portable, concise and simply formatted - a perfect practical companion Clear coloured images and illustrations bring the text to life Follows the Royal College of Anaesthetists postgraduate training and exam syllabus Summary boxes, more than 100 exam style questions, and OSCE stations and exam tips all aid the reader in exam revision Covers new equipment and fully updated relevant to current practice Suggested further reading fully updated New information on: Aladin Cassettes; Glostavent machine; CONTRAfluran system; videolaryngoscopy and high definition camera use in intubation and endoscopy; use of ultrasound in epidural; Penthrox; NRFit devices; Cell saver; ECMO

Neuroanesthesia contains the edited presentations of the 42nd Annual Postgraduate Course in Anesthesiology given by the Department of Anesthesiology at the University of Utah School of Medicine, February 1997. The chapters reflect recent advances in neurophysiology, pharmacology and monitoring related to the practice of neuroanesthesiology. The sections on central nervous system trauma, intraoperative management, brain protection and postoperative care provide a conceptual framework for current clinical practices. This textbook is the fifteenth in a continuing series documenting the proceedings of the Postgraduate Course of the Department of Anesthesiology of the University of Utah School of Medicine. It reflects, as well as past and future volumes, the rapid and continuing evolution of anesthesia in the last years of the twentieth century.

This thoughtful new book presents strategies for helping end-stage renal disease patients and their families deal with the psychosocial aspects of the chronic long-term illness. Technological advances in the treatment of this disease have offered much hope for improved quality in living which has led caregivers to have a greater concern for preserving the quality of life of their patients. In Psychosocial Aspects of End-Stage Renal Disease leaders in the field of many disciplines share knowledge and reveal problems that are still evident to them in the confrontation with this potentially fatal illness.Five comprehensive sections devote special attention to the different areas of concern for the psychosocial well-being of end-stage renal disease patients. The impact of renal disease on family relationships is covered by examining issues of family responses and coping measures such as marital and family reactions to home and hospital dialysis treatment. Ethical issues in treatment are explored, including the ethics of treatment refusal and a Jewish perspective on kidney transplants. Relations between staff and patients and a timely section on renal disease and special populations, particularly the elderly and AIDS patients, make up the final two sections of this informative volume. Professionals in all allied health disciplines will benefit from this important volume as it demonstrates a model approach, if not the definitive one, for the treatment of the psychosocial aspects of end-stage renal disease as well as other chronic illnesses.

Pain is a complex experience, influenced by many variables. There is currently growing interest in the influence of sex and gender on the experience of pain. The fact that there are sex differences in pain and analgesia is now a well-recognized phenomenon within the field of pain medicine. However, the specific mechanisms underlying these differences remain somewhat poorly understood. Traditionally, these sex differences in pain experience have been attributed largely to psychological, behavioral and socio-cultural variables - in particular, a perceived greater willingness on the part of women to report painful symptoms and seek medical attention. Although psychosocial factors do influence pain perception, there is now substantial evidence to support a strong role for hormonal factors mediating sex differences in pain modulation. In Pain in Women: A Clinical Guide, a renowned group of experts in pain medicine breaks new ground in the field by synthesizing and elucidating the range of biological and neurohormonal factors underlying these conditions and clarifying potential treatment options based on these factors. The initial section of this unique title introduces the topic of pain in women and its importance and then goes on to describe hormonal and myofascial considerations in this patient population. The second section addresses specific pain disorders common in women and the various treatment options for these, including rehabilitative and complementary and alternative medicine (CAM) treatments. The third and final section covers the specific populations of the pregnant/postpartum woman, issues related to breast cancer, the female athlete, menopausal considerations and the role of physical therapy in women s health. Timely and state-of-the-art, Pain in Women: A Clinical Guide is an important new reference that fills a significant need in the developing area of pain medicine."

This issue will cover everything from various therapies to alleviate symptoms or help patients learn to cope to regain normal function of their hand/or upper extremity and resume daily activities, to mechanism/anatomy and outcomes and measurement of pain.

Some important constraints of anesthesia must be taken into consideration when the pharmacological properties of modern anesthetics are discussed. The most imp- tant of these could be that the target effect be achieved preferably within seconds, at most within a few minutes. Similarly, offset of drug action should be achieved within minutes rather hours. The target effects, such as unconsciousness, are pot- tially life-threatening, as are the side effects of modern anesthetics, such as respi- tory and cardiovascular depression. Finally, the patient's purposeful responses are not available to guide drug dosage, because, either the patient is unconscious, or more problematically, the patient is aware but unable to communicate pain because of neuromuscular blockade. These constraints were already recognised 35 years ago, when in 1972 Volume XXX entitled "Modern Inhalation Anesthetics" appeared in this Handbook Series. The present volume is meant as a follow up and extension of that volume. At the beginning of the 1970's anesthesia was commonly delivered by inhalation, with only very few exceptions. The clinical understanding of that time considered anesthesia as a unique state achieved by any of the inhalation anesthetics, in- pendent of their specific molecular structure. "The very mechanism of anesthetic action at the biophase" was discussed within the theoretical framework of the "u- tary theory of narcosis".

The volume of elderly patients requiring anesthesia and surgery is growing rapidly. Thirty-five percent of surgeries are performed on patients older than 65 years, and in general, these patients have higher morbidity and mortality rates after anesthesia compared with their younger counterparts. One of the major challenges of treating elderly patients is the heterogeneity of the geriatric population-and the need to individualize care for each patient to provide the best outcome.

Readers have access to legions of books dealing with the molecular, genetic, neurochemical, neurophysiological, neuroanatomical, neuroradiological and psychological aspects of pain as well as with the clinical approaches to pain from various medical disciplines. Why then is it necessary to publish a book on the pathophysiologyofpain perception? Pain can result either from noxious events due to lesions, injuries, diseases, etc. , or from disturbances in the system transducing, transforming, and processing the potential pain signal or from an interaction of both. Under certain pathological conditions, the pain-processing system, which includes both physiological and psychological components, can produce the experience of pain in the absence of any peripheral noxious event. This book primarily ex- amines these pathological alterations in the pain-signalling system, and the authors provide information on the functioning of the pain-processing system under normal and pathological conditions. The understanding of pain perception is essential for optimal diagnosis and treatment of acute and chronic pain. Considerable evidence now indicates that alterations in pain per- ception are characteristic of many clinical pain states. Whether disturbed pain perception is a truly etiological or only a maintaining factor-c-or even a mere epiphenomenon of chronic functional pain-is reviewed in detail by L. Arendt-Nielsen, C. R. Covelli, R. B. Fillingim,]. M. Gillespie, T. Graven-Nielsen, E. Kosek, S. Lautenbacher, M. Peters, A. Pielsticker, DO. Price, G. B. Rollman, P. Svensson and G. N. Verne for headache, back pain, fibromyalgia, myofascial pain, temporomandibular pain disorder, irritable bowel syndrome and menstrual cycle-related pain disorders.

Using sample administrative and clinical protocols that any hospital can use, this book gives a detailed account of how to set up and run an observation unit and reviews all medical conditions in which observation medicine may be beneficial. In addition to clinical topics such as improving patient outcomes and avoiding readmissions, it also includes practical topics such as design, staffing, and daily operations; fiscal aspects, such as coding, billing, and reimbursement; regulatory concerns, such as aligning case management and utilization review with observation; nursing considerations; and more. The future of observation medicine, and how it can help solve the healthcare crisis from costs to access, is also discussed. Although based on US practices, this book is also applicable to an international audience, and contains instructions for implementing observation in any setting or locale and in any type of hospital or other appropriate facility.

Offering highly visual, easy-to-read coverage of the full range of anesthesia equipment in use today, this authoritative reference is your go-to text for objective, informed answers to ensure optimal patient safety. Anesthesia Equipment, 3rd Edition, provides detailed information on the intricate workings of each device or workstation, keeping you fully up to date and helping you meet both equipment and patient care challenges. Remains unequalled in both depth and breadth of coverage, offering readable, concise guidance on all aspects of today's anesthesia machines and equipment. Details the latest machines, vaporizers, ventilators, breathing systems, vigilance, ergonomics, and simulation. Improves your understanding of the physical principles of equipment, the rationale for its use, delivery systems for inhalational anesthesia, systems monitoring, hazards and safety features, maintenance and quality assurance, special situations/equipment for non-routine adult anesthesia, and future directions for the field. Includes ASA Practice Parameters for care, and helps you ensure patient safety with detailed advice on risk management and medicolegal implications of equipment use. Highlights the text with hundreds of full-color line drawings and photographs, graphs, and charts. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

This book provides an authoritative overview of botulinum neurotoxin (BoNT) treatment menus for 16 pain categories with an evidence-based literature review on each pain disorder, illustrative figures showing anatomy and techniques Introductory chapters cover basic information about the mechanism, function and the analgesic effects of the BoNTs based on the data derived from animal studies. Clinical chapters define pain in conditions such as post-herpetic and post-traumatic neuralgias, plantar fasciitis, low back pain, post-surgical pain syndromes and migraine in detail, provide discussion of current modes of treatment and updated information on BoNT therapy. Each chapter also includes illustrative case histories. The new edition is updated with all the new findings since the explosion in research and literature since 2015. New chapters on the history and pain in dentistry round out the update. Botulinum Toxin Treatment of Pain Disorders provides an invaluable resource for clinicians and researchers involved in the treatment of pain disorders including neurologists, pain medicine specialists, anesthesiologists, internists, those conducting research in pharmacology and toxicology as well as students in these areas.

Pain medication is widely used to treat patients who suffer from acute and chronic pain. however, it is not the only treatment option available for managing traumatic and chronic upper body pain. Chinese medicine is a popular option without the risk of adverse side effects that may come with opioid use. Chinese Medicine for Upper Body Pain further explores other pain management options, introducing treatments such as acupuncture, herbal medicine, and Tui Na (Chinese bodywork). This book provides concise explanations in terms of anatomy, pathology, and etiology for both Western and Chinese medicine, and also provides selfcare instructions that are effective and easy to follow. Key Features: Introduces treatments in Chinese medicine including acupuncture with traditional methods such as acupuncture point selection and its modifications, electroacupuncture, point bleeding, auricular medicine, cupping, and moxibustion; herbal formulas with their sources and modifications, and Tui Na therapy Recommends dietary, exercise, and selfcare protocols for patients Includes photos for reference and ease of understanding This book is suitable for healthcare practitioners and students of Chinese medicine practices as well as patients who want to better understand and mitigate their pain. Along with Chinese Medicine for Lower Body Pain (ISBN: 9780367235857), the author covers the use of Chinese medicine for pain management for the complete body.

The first two "Brain Heart Conferences" in Jerusalem in 1978 and 1983 were based upon the common interests of clinically orientated neurologists and cardiologists in the problems of centr'al autonomic control and autonomic disturbances of the cardiovascular system. The relatively slow scientific progress, at least clinically, in this area may be due to the fact that neither cardiologists nor neurologists felt competent in both topics. Furthermore, it has become increasingly difficult to have an overall view of the basic research and its clinical applications in this field. New research methods, based on a comtination of morphological, biochemical, and physiological techniques, have enabled the functional differentiation of various areas of the brain and subsequently also of the autonomic nervous system. The simple dualistic concept of an antagonistic sympathetic-parasympathetic regulation of the circulatory system is no longer valid. It is clear that numerous neurotransmitters, in particular the neuropeptides, are involved in a highly differentiated subdivision of the autonomic system. One of the aims of the IIIrd International Brain Heart Conference was therefore to supply a synopsis of the latest developments in basic research undertaken in this field by exceptionally competent scientists, to clinically orientated neurologists and cardiologists, and thus to provide new impulses for clinical research.

Opioids are responsible for the vast majority of preventable deaths related to drug use, and opioid crisis is a serious international health problem. Opioids are also the mainstay in pain treatment and are invaluable tools in palliative care. The purpose of this book is to present an overview of the complex field of opioid pharmacology through evidence-based chapters in clear language backed up with sound scientific evidence, providing researchers and health professionals with a firm understanding of their effects and mechanisms of action. The authors present an overview of the history of opioids from ancient civilizations to the current opioid crisis, covering state-of-the-art advances on opioid-induced signal transduction, opioids in pain management, and the neuroinflammatory effects of opioids. Also discussed are opioid use disorders and their treatment. The authors also review the growing body of evidence of opioid effects on innate and adaptive immune responses, discussing the molecules involved in the crosstalk between opioids and innate immunity receptors to provide an updated view of those compounds as important regulators of inflammation and host defense against pathogens and damage. The overall purpose is to provide the reader with a deeper knowledge of this field despite the complexities associated with the existence of numerous ligands, receptor subtypes, and complex pharmacological profiles. To this end, the chapter authors are specialists in the field who also have extensive experience in teaching, hoping to lend their expertise in translating complex concepts into comprehensive and clear explanations.